Active NPI
Charles Dotson, OD
- Optometrist
- Logan, WV
National Provider Identifier
1548099583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3041-IOD
- Practice address
- 407 George Kostas Dr
Logan, WV 25601-3747 - Phone
- (304) 752-2020
- Fax
- (304) 752-5600
- NPI assigned
- Jul 29, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3041-IOD | WV | Primary |
Addresses
Primary practice location
407 George Kostas Dr
Logan, WV 25601-3747
Mailing address
407 George Kostas Dr
Logan, WV 25601-3747
Phone (304) 752-2020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
407 George Kostas Dr
Logan, WV 25601-3747
Phone (304) 752-2020
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 20 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3041-IOD | WV | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| White Eye Care Center Inc. | Optometrist | Current | Accepting new patients |
Locations
407 George Kostas Dr
Logan, WV 25601
Phone (304) 752-2020
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- Logan, WV
- NPI 1023118841
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722211200000",
"number": "1548099583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 GEORGE KOSTAS DR",
"city": "LOGAN",
"state": "WV",
"postal_code": "256013747",
"telephone_number": "304-752-2020",
"fax_number": "304-752-5600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407 GEORGE KOSTAS DR",
"city": "LOGAN",
"state": "WV",
"postal_code": "256013747",
"telephone_number": "304-752-2020",
"fax_number": "304-752-5600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOTSON",
"first_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-07-29",
"last_updated": "2024-07-29",
"certification_date": "2024-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WV",
"license": "3041-IOD",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Logan, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.